Dear Pam,
Please share with  me your article on delaying breastfeeding. 
Parents are so in a hurry to do it while the baby is in hospital because so  
many insurance companies won't pay for it as an outpatient service.  We who  
work with newborns know that babies go into a downtime after the circ and may  
not breastfeed as well do to the procedure and now the use of 24% sucrose and  
locals for pain management.  By the time you get the baby back to his Mom  
his so saturated with sweets that he isn't interested in breastfeeding even if  
its for pain management.  Most Moms can't get enough expressed colostrum to  
use instead of the sucrose or they have just fed the baby and the doc comes  
rushing in to do it in a hurry and we can't get the expressed colostrum.  
Advising Moms ahead of time that they may be confronted with these  
challenges should be part of the informed consent. Many of our OBs will no  longer do 
circs and the Neonatologists are so swamped they don't like take  a lot of time 
to discuss it. So to develop a really good circ information sheet  might be 
the answer.  Moms could get it and read it prior to signing the  consents.  In 
our hospital only a few of the Neos do circs so this might  even help them.  
Medicaid doesn't pay for circs and so many of the docs OB  or Neos have 
patients pay out of pocket and this often dissuades them from doing  it in hospital 
and they wait until they have the money and do it as an out  patient in the 
office (also no hospital charge for instrument tray). 
Does anyone have a form that speaks to circumcision and breastfeeding that  
they use as a handout?
Leanne Jewell RNC, IBCLC, LCCE, FACCE
South Miami, Fl
 
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